Assessment of Nutritional Status in Children and Adolescents with Congenital Heart Defects in Germany—Comparison with Data from the KiGGS Study

Background: Malnutrition and poor weight gain are frequent features in congenital heart disease (CHD) and may have different causes. To obtain representative data on the nutritional status, and potential influencing factors, in school-aged children and adolescents with CHD, we performed a nationwide online survey.

Methods: All patients aged 6 to 17 years registered in the German National Register for Congenital Heart Defects (NRCHD) were contacted by email and asked to participate in the survey using the KiGGS (German Health Interview and Examination Survey for Children and Adolescents) self-administered Food Frequency Questionnaire. This allowed the comparison with a representative age-matched subset of 4,569 participants from the KiGGS study. The questionnaire for CHD-patients was amended by specific questions regarding nutritional counseling.

Results: Complete datasets of 894 patients (mean age of 12.5 ± 3.1 years; 47.2% female) were available for evaluation. The study participants were allocated according to the anatomic complexity into simple (23.8%), moderate (37.8%) and complex CHD (38.4%). While fruits and vegetables were similarly consumed, the consumption of sugar-containing food (p < 0.001) and fast food (p < 0.05) was significantly lower among CHD-patients compared with healthy children. Consequently, overweight and obesity was only rarely detected in CHD-patients. Compared with KiGGS participants, children with CHD showed significantly lower body mass index (BMI) (p < 0.001), while children with complex and moderate CHD had the lowest BMI. Multiple regression analyses revealed age, physical activity, CHD severity and number of previous interventions as independent factors related to BMI levels. In contrast to KiGGS, no correlation was found between BMI and consumption of fast food as well as gender. Nutritional counseling by a dietician (covered by health insurance in 75.3%) has been received by 146 (16.3%) of the CHD-patients, most frequently in complex CHD (23% of all complex CHD patients).

Conclusion: According to our results, underweight is frequently detected in school-aged children and adolescents with CHD, mainly in complex CHD. Nutritional status, reflected by BMI, is related to age, physical activity, CHD severity, and number of interventions. Nutritional counseling, as an important component of multidisciplinary care for nutrition disorders, should be considered especially in children with complex CHD.

Publication History

Article published online:
13 February 2024